Tag: facelift

Elle Macpherson, has been an advocate of natural beauty, crediting an active lifestyle and a plant-based diet as the secrets behind her age-defying appearance. Beverly Hills plastic surgeon Dr Randal Haworth, believes that Elle may have also undergone a few cosmetic procedures to maintain her effortless beauty over the years. Dr Haworth stated: ‘The plan is simple when maintaining the beauty of an already beautiful woman. Elle’s genetic blueprint is flawless, therefore a plastic surgeon would have to follow the plan to a “T”, never veering away from her natural features.’

Dr Haworth believes that Elle may have had a subtle rhinoplasty in her thirties, resulting in ‘a squared nasal tip flanked by vertical grooves extending down to her nostril rims’. Dr Haworth also claims that she may have gone under the needle to enhance her already-striking visage. ‘Her lips are fuller in a subtle way, indicating she may have had them plumped with an off-the-shelf filler such as Juvéderm,’ he claimed. ‘These are some of the type of subtle “tweaks” that may have helped help Elle Macpherson radiate her natural beauty in a casual yet confident manner,’ he surmised.

Elle has made no secret of her laissez-faire approach to beauty and aging, telling This Morning in June that she is proud of her natural look. In 2016, Elle admitted PEOPLE magazine that she had played around with cosmetic procedures to fight wrinkles.

Catriona Rowntree, who looks like she has hardly aged since starting her TV career in her twenties, has never confirmed or denied having Botox or fillers. Dr. Haworth told Daily Mail Australia: ‘It is only on close inspection that clues arise as to what she may have done to keep her appearance polished.’ The former Getaway host Catriona Rowntree has been a fixture on Australian television for more than two decades. Haworth has offered his expert opinion on how she has maintained her youthful complexion over the years.

According to Beverly Hills plastic surgeon Dr. Randal Haworth, there are tell-tale signs that suggest she has had ‘subtle’ procedures to her face. ‘Over the years, Catriona is, what I call, a perennial beauty. Starting off as a radiantly attractive woman, any aesthetic procedures she receives must be subtle and “under the radar”, so to speak,’ he explained. ‘It seems that she hasn’t aged one iota since the 1990s,’ Dr. Haworth added.

Rebecca Judd, is known for her glamorous and striking appearance. The Melbourne socialite has always denied plastic surgery rumors, a Beverly Hills plastic surgeon claims her flawless visage is far from natural. Dr. Randal Haworth said before and after photos suggest the Postcards presenter may have had ‘cosmetic fillers’ or a ‘fat transfer’ at some point.

‘Earlier, her eyes were deep set because they were surrounded by noticeable hollowing,’ Dr. Haworth said referring to photos of Bec from more than 10 years ago. ‘My most age-defying patients who make looking beautiful as effortless as breathing are the ones who work at it the hardest.’ Daily Mail Australia has reached out to Bec for comment. In 2013, the mother-of-four acknowledged that she invests ‘a lot of time, effort and cash’ into her appearance and said she gets ‘shocking eye bags.’ She previously credited Melbourne skin clinic Liberty Belle for her glowing skin and gets everything from exfoliation to laser treatments. In 2008, Bec, who is the wife of former AFL star Chris, denied plastic surgery rumours.

The Australian cricket ace, has always denied having a nip and tuck and instead credits his youthful appearance on his dedication to healthy living. Dr. Haworth says the giveaway is Warne’s eyebrow shape as it’s now ‘reminiscent of Jack Nicholson’s’. Shane Warne’s changing face has sparked speculation for years that he’s had plastic surgery.

“I suspect that he has dabbled with Botox and perhaps some fillers here and there,” Dr. Haworth told the Daily Mail. “While women’s faces tend to look younger and softer with the right amount of fat, men’s faces tend to look better with weight loss. Shane’s is no exception – his face has become more chiseled, defined and handsome,” he stated. “What’s more interesting is the shape of his eyebrows. It has drastically changed from his younger self when his naturally low-set eyebrows were especially drooping at their outer edge.”

When appearing on I’m A Celebrity in 2016, Warne denied having anything done to his face. He explained if he had cosmetic surgery then he would be happy to admit it.

Beverly Hills plastic surgeon Dr. Randal Haworth believes that Kerri-Anne Kennerley may have also gone under the knife in recent years. She has never been shy about admitting she uses non-surgical treatments such as Botox and Fraxel laser to maintain her age-defying looks.

‘Mrs Kennerley looks better than ever compared to her former self 15 years ago. Though maintaining a healthy lifestyle and weight certainly helps, based on recent photographs, I feel that she enlisted the expertise of a plastic surgeon along the way’, Haworth told Daily Mail Australia this week. Dr. Haworth went on to speculate that Kerri-Anne has used dermal fillers to maintain her youthful complexion.

‘The small protruding ridges below the inside corners of her lower eyes while smiling indicate that Kerri-Anne may have had injections, such as Juvéderm Silk or Restylane, to fill her lower under-eye hollows at some point,’ Dr. Haworth claimed. Kerri-Anne, who hosted Midday from 1996 to 1998, recently confessed to 9Honey that she has no interest in looking ‘natural’ as she ages.

‘We don’t want to go natural! Natural is for 6am in the morning, I don’t think so!’ Kerri-Anne said. Last year, she also told The Australian Women’s Weekly that Botox and Fraxel laser were all part of her beauty routine.

Alex Perry, whose celebrity fans include Rihanna and Kim Kardashian, told Yahoo in 2013 that he is not ashamed of using fillers and Botox. In 2016, the Australia’s Next Top Model judge was criticized for his appearance by one of the show’s contestants, 21-year-old Kassidy Ure. After Alex criticized her photos, she sniped back: ‘At least my lips are real!’

Beverly Hills plastic surgeon Dr. Randal Haworth accused the Australian fashion designer of ‘excessive’ use of anti-wrinkle injections. Haworth observed how Alex, 55, looks remarkably different in before and after photos and may have taken things too far. The Beverly Hills surgeon-to-the-stars claimed Alex’s face now looks ‘crowded’ as a result of ‘too much’ filler.

Dr. Haworth stated that ‘Compared to his younger self, his face is now “crowded”, making his eyes appear smaller and closer set. Most likely, a generous recipe of injected filler and more than a drizzle of Botox in and around his forehead, brows and temples contributed to this look.’

Very few surgeons in the world understand aesthetics to the point where they can be a true hyperaesthetic facial plastic surgeon specialist. A hyperesthetic specialist is similar to the conductor of an orchestra-he or she needs to know all the instruments better than the individual players in order to “orchestrate” them to create melodious harmony without dissonance. One of the keys to create visual harmony in the face is mastering lip rejuvenation surgery-it’s not just about adding volume (which is essentially what most practitioners and patients equate with lip enhancement), it’s about mastering the shape of both the upper and lower lip. Patients travel from all corners of the globe to top Beverly Hills plastic surgeon and lip augmentation specialist, Dr Haworth to undergo hyperesthetic change, which may include any number of surgical art performances including a high-profile facelift, endoscopic brow lift, blepharoplasty, rhinoplasty or his lip reshaping signature surgery! https://youtu.be/cI3nEq5R3x8

Good plastic surgery is invisible but many people insist that they can always spot anyone who has had plastic surgery. For example, they claim they can always spot a celebrity with a facelift and list those with obviously sad results that garner all the press. You can refer to the three attached photographs as examples of such. (They go on to name others who have not had any plastic surgery and when I in turn correct them, they express bewildered disbelief.)
Joan Rivers with look-at-me pixie-ear deformity

Bruce Jenner with a plain-as-day pixie-ear deformity after a facelift

Mickey Rourke sporting his obvious Pixie-ear and man-bun on the red carpet

However, this blog post is not about good plastic surgery, it is about the bad and the ugly. There are many signs that scream “facelift”:

1. Overly pulled face skin with diagonal grooves

2. Altered hairlines such as pulled-back sideburns

3. Widened, non-hair-bearing scars with step-offs in the natural hairline behind the ear

4. Distorted anatomy in front of the ear canal due to effacement of the delicate tragus cartilage and finally…

5.”Pixie ear”.

Most of these aforementioned problems stem from misplaced anchoring of the newly redraped skin flaps resulting in needlessly excessive tension across potentially visible scars. One immutable rule in plastic surgery dictates that such increased tension can create widened scars, hair loss and distorted anatomy. Yet, despite these well-documented problems, I unfortunately still see many patients who seek correction of these stigmata of ill-conceived facelifts.

Correcting these problems is not an easy task. Generally, a secondary facelift needs to be performed to release enough skin so that both scars can be removed and closure achieved in a tension-free matter. If it happens to be a lucky day, scars that were placed in front of the ear can even be moved more posteriorly to within the ear canal as in this example of a facelift I performed in order to not only make her look younger but also remove her telltale signs of past substandard surgery.

Pixie ear deformity and tired appearance after previous facelift

Note correction of pixie-ear deformity after revision facelift. An endoscopic brow lift, fat transfer, upper lip lift and a lower blepharoplasty were also performed

By trade-offs I am referring to subtle and sometimes significant alterations in your appearance that will be incurred by undergoing a certain plastic surgical procedure. It is the doctor’s responsibility to inform the patient of these trade-offs (including risks of complications) while it is the patient’s responsibility to make an informed decision to proceed if he or she feels that the benefits of the surgery will outweigh the risks and trade-offs.

Examples of such trade-offs are the scars in and around the ear that result from a facelift. Even though they may be near invisible, they are scars nonetheless. The majority of patients feel that benefits of the facelift outweighed any of the associated trade-offs. Similarly, patients who undergo an abdominoplasty (tummy tuck), mastopexy (breast lift) or brachioplasty (arm lift) should be fully aware that they will develop scars from those procedures. Though the majority will heal well with very acceptable scars, most of the time the scars will be visible to some degree.

Patients who undergo a rhinoplasty must understand that their nose will be numb, stiff and hard for up to 3 months or more while swelling can persist for 1 to 2 years. Numbness from a facelift or a browlift can last many months as well. Despite understanding these trade-offs, the vast majority of patients have no problem undergoing these procedures once they have decided to do so.

Over the years, I have found it curious that a small minority of patients undergoing lip reshaping surgery in the form of upper lip lifts and V-Y plasties had unrealistic expectations in terms of their healing and results. They were surprised even angry that they experienced numbness, stiffness and associated scarring. Sometimes a very subtle change in the nostril position occurred after the surgery. These trade-offs may arise even though the result of the upper lip lift is successful from the aesthetic standpoint-in other words, the net benefit in the sensual-youthful-beauty quotient for the face has been increased. However, a few may consider the lip lift a failure if they have experienced even a slight degree in any of these trade-offs.

Though these trade-offs can mostly be successfully reversed, a patient should not elect to undergo such a procedure if he or she will not accept that these can be normal aspects of the procedure. If one thinks about it, an upper lip lift will have its trade-offs in the same way other procedures would have their own yet it perhaps gets more attention than other anatomical features of the face because the lips are expected to not only look beautiful but also function as well.

And function they do, more than any other part of the face. Indeed, lips are used to express, emote, eat, kiss and speak-essentially they move millions of times a day! Because of these strong repetitive muscle forces around the nasal and oral region the plastic surgeon must create a strong upper lip lift that will resist these forces in order to achieve a result that is long-lasting, with minimal scarring and nasal distortion.

In fact, lip shaping procedures are the most challenging of all facial plastic surgeries, even rhinoplasties. Though the success of facelifts are measured in centimeters, brow lifts in increments of 2 to 4 mm and rhinoplasties in millimeters, lip reshaping surgery is measured in quarter-to-an-eighth of a millimeter! With those scales, one can almost consider this close to microsurgery.

In 2014, it would be a miracle to undergo an upper lip lift with an unequivocal guarantee of no scarring, nasal distortion, prolonged minor sensory changes and stiffness. If you are contemplating undergoing an upper lip lift but will not tolerate any of these tradeoffs, I suggest you avoid the procedure altogether and wait for that miracle to happen.

As with any service industry, there are convenience stop businesses and destination businesses. You see that with restaurants (think of McDonald’s or Chili’s versus French Laundry, one of the best restaurants in the United States) and you see this concept applicable to the plastic surgery business. I stress the term business and not medical field for a reason in this essay. I can safely say that most people that pursue higher education in any country do so to seek a better life, better pay and have more opportunities come their way. Of course, most scrupulous doctors experience immense satisfaction from treating their patients as well and, cynically speaking, are not simply in it for the financial award.

Like all professionals, doctors do seek out (and deserve) a certain financial reward for all the years of dedication, study, stress and life sacrifice they undergo in order to carry out their profession and deliver the best care they can to their patients. However, in this day and age of increasing competition and commoditization in all aspects of health care including plastic surgery, surgeons are forced to perform more surgeries at lower costs and possibly increased medical risk to patients. This alarming trend can especially be seen in plastic surgery where the end results of a hastily performed surgery are not hidden within a body cavity but are plainly visible on the face. Some of my colleagues brag about the speed at which they perform a surgery citing the many corners that they “cut” during an operation as unnecessary steps (no pun intended). I suppose they feel more akin to a Usain Bolt than that of a gifted watchmaker.

This brings me to the title of this blog post-The Lifestyle Lift. To the unsuspecting public this facelift is heavily marketed as a viable, simpler, safer, faster quality facelift at a fraction of the price. In fact, this facelift is an overly simplified distillation of pre-existing ideas wrapped in a new packaging as something brand-new and revolutionary. The one aspect that is revolutionary about this facelift is that it is one of the first surgeries that has been rebranded and marketed directly to the “consumer”. The company then refers the “consumer’ to one of their participating surgeons in the network to become a patient. Unfortunately, as a Beverly Hills plastic surgeon board-certified by the American Board of plastic surgery, I have seen many results of this “Lifestyle Lift” that reek “cookie-cutter surgery” in which performance is measured in terms of speed and not quality.

I have seen many unacceptable, hideously widened scars most probably stemming from the fact that the surgeon did not perform a wide enough dissection to allow a tension-free closure (which is tantamount to a good scar). I have also consulted with many patients who were dismayed by how the “Lifestyle Lift” failed to meet their expected goals with incomplete treatment of their jowls, neck and midface.

While it is true that all surgeons have their small subset of unhappy patients either because of unrealistic expectations, sub-optimal results or unexpected complications, the large percentage of unhappy patients complaining of their “Lifestyle Lift” is too hard to ignore. For a good article on the subject that appeared in Plastic Surgery Practice.